16 Spectrum of infections during juvenile idiopathic arthritis

Abstract Background The incidence of infections in patients with chronic inflammatory rheumatic disease is increased. It is often due to the disease itself and to the immunosuppressive treatments used. Objectives To assess the incidence of infections during JIA. Methods We conducted a repeated cross-sectional study including 29 patients followed for JIA according to the International League of Associations for Rheumatology (ILAR) criteria over a period from 1994 to 2022. Sociodemographic and anthropometric parameters, clinical data, biological assessments, and prescribed therapies were collected. We identified patients who had at least one infectious episode during their follow-up. Results There were 17 women and 12 men. The mean age was 35.69 ± 11.72 [18–61] years. The polyarticular form was seen in 55.2% of cases. The mean age of disease onset was 11.10 ± 4.25 [2–16] years. The average disease duration was 24.48 ± 12.76 [1–47] years. Diabetes and arterial hypertension were the main comorbidities associated with JIA, observed in 13.8% of cases each. At least one extra-articular manifestation was noted in 16 cases: pulmonary (3 cases), cardiac (4 cases), renal (2 cases), cutaneous (4 cases) and ocular (7 cases). The most prescribed DMARDs was Methotrexate in 79.3% (n = 23), biotherapy was used in 3 (10.3%), NSAIDs and corticosteroids were used in 62.1% (n = 18) and 69% (n = 20) respectively. All the infections observed in our population were of community origin. Urinary tract infection was the most common infection (n = 5). Bronchopulmonary infections were observed in 2 cases including a case of tuberculosis. Sub periosteal abscess of the femur was also seen in one of the patients. Regarding the SARS-CoV-2 infection, 6 patients were infected, 2 of whom required hospitalization, including one in the intensive care. Conclusion The risk of infections is increased during JIA. This is due to the immunosuppression induced by the disease, the treatment, and comorbidities.


Background
The incidence of infections in patients with chronic inflammatory rheumatic disease is increased. It is often due to the disease itself and to the immunosuppressive treatments used. Objectives To assess the incidence of infections during JIA.

Methods
We conducted a repeated cross-sectional study including 29 patients followed for JIA according to the International League of Associations for Rheumatology (ILAR) criteria over a period from 1994 to 2022. Sociodemographic and anthropometric parameters, clinical data, biological assessments, and prescribed therapies were collected. We identified patients who had at least one infectious episode during their follow-up.

Conclusion
The risk of infections is increased during JIA. This is due to the immunosuppression induced by the disease, the treatment, and comorbidities.

Objectives
To identify the factors associated with anaemia in JIA.

Methods
We conducted a retrospective study including adults with longstanding JIA according to the International League of Associations for Rheumatology (ILAR) criteria over a period of 28 years . Demographic, clinical, biological, and radiographic data were collected. These parameters were compared according to the presence or absence of anaemia.

Results
Seventeen women and 12 men were enrolled. NSAIDs, corticosteroids and methotrexate were used in 62.1% (n ¼ 18), 69% (n ¼ 20) and 79.3% (n ¼ 23) respectively. Anaemia was noted in 69% (n ¼ 20) of cases, it was hypochromic in 8 cases and microcytic in 11 cases. The mean haemoglobin value was 11.31 2.10 [6.5-15] g/dl. Anaemia was associated with the following parameters in our study: female sex (88.2% vs 41.7%; p ¼ 0.008), absence of anti-nuclear antibodies (76.9% vs 20%; p ¼ 0.026) and corticosteroid therapy (85% vs 33.3%; p ¼ 0.005). However, the comparison of patients according to the presence of anaemia did not show any significant difference for these parameters: age, age at onset, diagnostic delay, duration of symptoms, extra-articular manifestations, CRP value, presence of biological inflammatory syndrome, rheumatoid factor, ACPA, erosive nature and treatment (NSAIDs and methotrexate). Conclusion Anaemia is common in JIA. Its treatment is part of the overall management of the disease. Background Juvenile idiopathic arthritis (JIA) is chronic inflammatory arthritis of childhood that may result in persistent and disabling foot impairments. Foot disorders are common in JIA with a prevalence estimated at over 90%. Many factors can worsen foot disorders in these patients. The influence of weight on foot disorders is poorly studied.

Objectives
To examine associations between weight and foot disorders in patients with JIA.

Methods
Patients with a diagnosis of JIA, based on the International League of Associations for Rheumatology (ILAR) criteria were included. Age, gender, weight, characteristics of the disease and of foot pain were noted. A specialized podiatric examination was performed.

Results
Thirty-two patients were included. The mean age was 12.2 AE 2.9 [5-18]. Forty-three percent of the patients were boys (n ¼ 14). The mean age of disease onset was 8.5 AE 3.9 [3-15]. Only one patient had a triggering factor (elbow fracture). The most common type of JIA was oligoarthritis in 12 cases, then enthesitis-related in 8 cases, polyarthritis without rheumatoid factor in 3 cases, polyarthritis with positive rheumatoid factor in 1 case, psoriatic arthritis in 3 cases, systemic arthritis in 1 case and undifferentiated arthritis in 4 cases. The mean weight was 43.5 kg . Only 28% (n ¼ 9) of the children had a normal weight for their age, 41% (n ¼ 13) of them had a low weight for their age and 31% (n ¼ 10) of them had overweight. Ten patients had foot pain: hindfoot pain in 5 patients, midfoot pain in 3 patients, and forefoot pain in 2 patients. Foot deformities were found in E POSTERS ii7